Pamela Saha

Ethical responsibilities of the clinical engineer.

Because of the growth of medical technology, Clinical Engineers have increased responsibilities in respect to this new technology and so to modern medicine itself. This results in a need to ensure that an ethical consciousness of responsibilities to patients, physicians, and institutions grows within Clinical Engineers as they move into evermore important roles within the health care system. Clinical Engineers must have clearly defined roles, as well as authority acknowledged and supported by other health care professionals. Most importantly, Clinical Engineers themeselves must recognize the seriousness of their professional responsibilities as they contribute to the maintenance of equipment, use and design instrumentation, and fulfill roles in administration, management, and research. As members of the health care team, Clinical Engineers must be prepared to face ethical issues arising from defective or inadequate equipment, hazards and incidents, scarcity of resources, conflict of interest, confidentiality, clinical research, “truth-telling,” and care of the terminally ill.

THE NEED OF BIOMEDICAL ETHICS TRAINING IN BIOENGINEERING

ABSTRACT The need for biomedical ethics training for bioengineers is discussed. Such training will be helpful to: 1) guide conducting human and animal experimentation; 2) meet the legal responsibilities associated with device or implant design; 3) reduce burnout of clinical engineers and 4) decide priorities in research and development. The need for adopting a Code of Ethics for the biomedical engineering profession is also pointed out.

Impact of managed care on the development of new medical technology: ethical concerns

During the last three decades, development of new medical technology has been largely responsible for the spectacular advances in the diagnosis and treatment of many human diseases. This has contributed to improved medical care of our population. However, concerns have been raised that in todays managed care environment of health care, introduction of new medical technology will be difficult. Cost-sensitive health care providers should consider various ethical issues involved before demanding that only those technologies that save money and show highly positive cost benefit ratio will be reimbursed. The impact of such considerations on the innovations of new medical devices and their developments is discussed.

Guiding patients toward prudent use of technologies.

A physician with a patient who demands a diagnostic test should focus on the patient-physician relationship and appropriate use of resources. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.

Conflicts of values and biodefense measures

Today, we are faced with an enemy that blends into the fabric of our society and has connections internationally with friends and foes alike. Such an enemy can exploit the nature of our free and open society with impunity. We freely disclose information regarding much of our technology and we have an open government answerable to the public to a degree rarely seen anywhere else in the world This certainly suggests a need to close the gates to protect ourselves from those who would infiltrate us for ill will. We must suffer imposed restrictions on ourselves in order to do so as there are no simple methods to distinguish the enemy from our own in a variety of settings. After September 11, 2001, the anthrax scare, the concern over small pox, and other bioterrorist tactics, we can easily conclude that our concern is not exaggerated.

Introduction of new medical technologies: an international and ethical perspective

Recent advances in biomedical technologies have significantly improved our capacities for the diagnosis and treatment of medical ailments. However, such technologies have also been blamed for increased medical costs. Ethical questions have been raised regarding the availability and use of such medical technologies. In recent years, the managed care companies in the USA have imposed severe cost constraints, thus limiting the development and introduction of new medical technologies. The ethical implications of such management issues are presented. Moreover, increased difficulty in getting FDA approval for medical technologies in the USA has recently led to the introduction of some technologies first in foreign countries. Ethical issues related to animal testing, clinical trials and use of medical technologies conducted overseas are discussed.